Assuntos
Anticoagulantes/efeitos adversos , Úlcera da Perna/induzido quimicamente , Varfarina/efeitos adversos , Idoso , Arteriopatias Oclusivas/tratamento farmacológico , Humanos , Masculino , Trombose/tratamento farmacológico , Insuficiência Venosa/induzido quimicamente , Vitamina K/antagonistas & inibidoresAssuntos
Eritema/patologia , Cogumelos Shiitake , Adulto , Eritema/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/etiologiaAssuntos
Adjuvantes Imunológicos/efeitos adversos , Aminoquinolinas/efeitos adversos , Transtornos do Humor/induzido quimicamente , Adjuvantes Imunológicos/administração & dosagem , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Aminoquinolinas/administração & dosagem , Feminino , Humanos , Imiquimode , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
BACKGROUND: Hypocomplementemic urticarial vasculitis, described by MacDuffie in 1973, is rare. Some doubt surrounds its classification. We report a case of hypocomplementemic urticarial vasculitis (MacDuffie syndrome) treated with dapsone with a favorable outcome. CASE REPORT: Over a number of years, a 43-year-old man presented urticarial vasculitis attacks with palpebral oedema and systemic symptoms such as fever and arthralgia. In 2006, MacDuffie syndrome was diagnosed on the grounds of positive anti-C1q antibodies. Treatment with dapsone was started and resulted in considerable improvement. DISCUSSION: Hypocomplementemic urticarial vasculitis is characterized by urticarial vasculitis lesions, leucocytoclastic vasculitis and systemic symptoms. The latter symptoms are similar to those of systemic lupus erythematosus (SLE), and some authors have suggested that MacDuffie syndrome may in fact belong to SLE. Diagnosis is based on clinical appearance, histology and the presence of anti-C1q antibodies. There is no specific treatment for hypocomplementemic urticarial vasculitis. Immunosuppressant therapy can be used for lesions refractory to systemic corticosteroids.
Assuntos
Autoanticorpos/imunologia , Complemento C1q/imunologia , Proteínas do Sistema Complemento/deficiência , Dapsona/uso terapêutico , Urticária/tratamento farmacológico , Vasculite Leucocitoclástica Cutânea/tratamento farmacológico , Adulto , Autoanticorpos/sangue , Diagnóstico Diferencial , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Indução de Remissão , Urticária/sangue , Urticária/imunologia , Vasculite Leucocitoclástica Cutânea/sangue , Vasculite Leucocitoclástica Cutânea/diagnóstico , Vasculite Leucocitoclástica Cutânea/imunologiaRESUMO
BACKGROUND: In Asia, toxic adverse effects due to picking or consumption of shiitake mushrooms (Lentinula edodes), the second most eaten mushroom in the world are well-known. Its increasing consumption in Europe, let us to emphasize that shiitake dermatitis would occur more and more frequently in Occident. CASE REPORT: A 78-year-old woman was referred for an erythematous, micro-papular, extremely pruriginous rash disseminated all over the body (including face and scalp). No drugs had been recently introduced. Questioning revealed that lesions appeared 48 hours after eating a great quantity of raw shiitake mushrooms, leading to the diagnosis of shiitake dermatitis. DISCUSSION: Clinical features of shiitake dermatitis are small, highly pruriginous, erythematous papules, generalized. They have a whole body spreading and in some area a linear disposition. It is a toxic reaction due to a toxin called lentinan. It occurs in the 48 hours after having eaten raw or slightly cooked mushrooms and vanishes into 10 days. Due to its increasing consumption in Occident, it is essential for European dermatologists to know this dermatosis and how to recognize it.
Assuntos
Dermatite/etiologia , Hipersensibilidade Alimentar/etiologia , Lentinano/efeitos adversos , Cogumelos Shiitake/química , Idoso , Emergências , Dermatoses Faciais/etiologia , Feminino , França , Humanos , Prurido/etiologiaRESUMO
Amphetamines are considered as narcotics in France. Their use induces modifications of the central nervous system and of the cardiovascular, respiratory and urinary systems by a sympathomimetic indirect effect. Here is reported the observation of a young woman who absorbed amphetamines causing a cardiogenic shock on a ground of acute myocarditis. The constitution of haemodynamic, respiratory and neurologic distresses lead to the endotracheal intubation of the patient. The haemodynamic status remaining shaky, despite the use of vasoactive drugs, a circulatory assistance by intra-aortic counter pulsation balloon was carried out. The initial echocardiography showed a left ventricular ejection fraction lower than 20%. Amphetamine's toxicity mechanisms still remain complicated; on cardiovascular plan, some cases of coronary artery spasm have been described. The coronarography, not accomplished immediately, was normal. Toxicological samples revealed an abnormally high amphetamines concentration. The severity of the cardiac attack was amplified by a Mycoplasma pneumoniae myocarditis. There was a positive evolution in eight days. Intoxication and infection can difficultly be dissociated in this case of cardiogenic shock.